Surgical delays common during flu epidemics

Every few years Winnipeg ERs get swamped with flu-related cases, mostly elderly patients with other underlying medical problems. When they’re sick enough to be admitted to hospital, and many are, the system backs up.Brian Donogh / Brian Donogh/Winnipeg Sun

“We believe that this is just another example of how the Pallister government’s cuts to health care are now starting to impact the health and the safety of Manitobans,” said Swan.

Does he have a point? Not really.

Every few years Winnipeg ERs get swamped with flu-related cases, mostly elderly patients with other underlying medical problems. When they’re sick enough to be admitted to hospital, and many are, the system backs up. It backs up not because hospitals don’t have enough hospital beds or because some government has closed an ER. It backs up because no hospital system is built to accommodate the largest spikes in patient volume. It would cost a fortune to do that and hundreds of beds would sit empty the vast majority of the time.

It would be a waste of health care resources.

Instead, during epidemics like these, flex beds are opened, more staff are called in and elective surgeries are often postponed. That’s because the hospital needs the inpatient beds on the surgical wards to accommodate the influx of patients coming through the ER.

That has happened in the past, including under the former NDP government. And it will happen again.

However, Swan says the situation has been made worse because of cuts to the system.

“The cuts that Pallister has made to the health care system have set the system up for failure,” said Swan.

Except there’s no evidence of that. The reality is, there’s just as much capacity in the hospital system today – maybe more – than there was in past years during flu epidemics.

That’s because one of the things the WRHA has been doing a better job of is reducing the number of long-term care patients waiting in hospital for placement. That has freed up inpatient beds to help absorb spikes in patient volumes. And even though Victoria Hospital’s ER has been turned into an urgent care centre, there are still community beds there being used to accommodate long-term care patients.

The WRHA’s new bed-management computer system has also significantly helped increase patient flow through hospitals.

Swan said cuts to clinics where flu shots are provided have also made the situation worse. However, the facts don’t align with that claim either. According to Manitoba Health, 19.6% of Manitobans got the flu shot as of Dec. 29, slightly higher than the 19.5% who got the shot last year by Jan. 6. In 2015-16, 17% of Manitobans got the flu shot as of Dec. 30 that season.

Swan said what the Pallister government needs to do is add more acute care beds to the system. However, that’s an old, simplistic solution that’s been tried before and always fails. If you add 100 permanent in-patient beds to the system, for example, they will fill up immediately and hospitals will be right back to square one.

What’s really needed is continued improvements to hospital patient flow, from ERs to resources downstream, including home care, personal care home beds and a greater emphasis on moving more long-term patients out of hospital. The WRHA knows that. And that’s what they’re doing to some degree.

Swan is right, though, that government needs to do far more to expand personal care home capacity. Those are part of the downstream resources that are needed. The Pallister government cancelled, or at least postponed, a number of personal care home projects in 2016. And while they have plans to add some PCH beds to the system, those projects aren’t expected to be online for at least two years.

Whether the WRHA will be able to weather the next flu epidemic after closing Concordia Hospital and turning Seven Oaks Hospital’s ER into an urgent care centre sometime in 2018 is another matter. According to government’s own wait time reduction task force, the WRHA has not expanded the remaining three acute care hospitals adequately to handle the expected patient volumes after those changes are complete.

We could be having an entirely different conversation this time next year.

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